Lower your birth rate, Kenyan families urged

Saturday August 29 2009

Children in a nursery at a maternity hospital. Kenyan women are giving birth to an average of five children, creating a population boom that has distorted growth projections, according to a recent report. Photo/AGENCIES

In Summary

Five children per woman is too much for the country to bear, they advise

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By DANIEL WESANGULA

Kenyan women are giving birth to an average of five children, creating a population boom that has distorted growth projections, according to a recent report.

Now experts are warning that the high birth rate could precipitate a population crisis as available resources will not be able to support the growing number of people.

The increased birth rate is being attributed in part to years of neglect following a previously successful family planning campaign that had significantly reduced Kenya’s population growth in the 1980s and early 1990s.

According to the Population Council of Kenya, in conjunction with other agencies that deal with family planning, the consequences of the population boom that began in the late 1990s are already being felt with regard to government planning.

According to reliable statistics, Kenya’s population growth rate went from 1.53 per cent in 2000 to an estimated 2.758 per cent in 2008.

The report, released last month, also shows that the decline in family planning programmes across the country due to funding cuts is the main cause of increase in births.

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The withdrawal of donor funding from government and private agencies family planning operations in the late 1990s may have resulted in an unexpected population boom.

“Every Kenyan knows it is the government’s duty to provide free basic education and free basic health care to its population, but we are just too many. This is a burden that the government might find hard to carry on its own,” said Walter Odhiambo, deputy country director of Marie Stopes Kenya, an NGO dealing with population and health.

Mr Odhiambo said a drastic reduction in the funding of family health projects by donor agencies is one of the main causes of the population increase.

The donors

“We know that the government is of good intentions. We know the division of family health is willing to educate the population on family planning. But the division doesn’t call the shots. The donors do,” he said.

In the late 1980s, family planning initiatives received more than Sh80 billion in donor aid in a year. By 2000, the amount of money coming in had dropped by more than 60 per cent to less than Sh32 billion.

At the height of its popularity two decades ago, the family planning initiative was credited with reducing the country’s fertility levels from eight children per woman to four.

At that time, all family health projections indicated that the number would decline further in subsequent years. But once the donor taps were closed, new projections had to be made.

According to reports, the decline in family planning programmes from the late 1990s resulted in the United Nations Population division revising Kenya’s projected population in 2050 from 44 million to 83 million.

Projections ahead of the just concluded census indicated that the country’s population had hit the 40 million mark, an increase of 10 million since the last count a decade ago.

Initially the original UN projections assumed that through a successful family planning programme, the reduction in the number of children born to Kenyan women would decline from an average of three births per woman by 2015 and two births per woman by 2050.

Family health and development experts say unchecked population growth is taking a heavy toll on the country’s ability to feed its people and provide basic social services like education and health care.

The experts further warn that the population boom is likely to hurt Kenya’s efforts to achieve a middle-income economy in the next 21 years, as spelt out in the Vision 2030 development plan.

“We are seeing the effects of limited resources among a large population. We rarely have enough food or enough water. If the growth is not checked, we may find ourselves in continuous crisis in the years to come,” said Tiberius Barasa of the governance and development programme at the Institute of Policy Analysis and Research (IPAR).

Vision 2030

“Development plans are made in relation to a country’s population growth. For us to achieve the goals set by the government in policies such as Vision 2030, population control must be taken into account.”

The current situation has led to Kenya’s losing its once praised population control programme in less than a decade. Currently, population growth in Kenya is higher than in other East African countries; Kenya is also one of the few countries to have recorded rapid population growth in the recent past.

But a resumption in donor funding may see the Kenya government and the private sector embark on another round of vigorous family planning campaigns similar to those held in the 1980s.

Previously, family health experts say, most of the funding came from the US government. However, during President George W. Bush’s eight-year administration, funding was shifted from family health initiatives, notably family planning, to other areas that were deemed more urgent.

“Many donors stopped funding family health initiatives. From the late 1990s to recently, HIV/Aids and malaria were regarded as the biggest threats to nations. Therefore a majority of funds were channelled to projects dealing with either of the two diseases,” said Mr Odhiambo.

Mr Muraguri Muchira, programme director at Family Health Options Kenya, said this resulted in not only in the closure of a number of family health establishments but also in professionals abandoning the family health sector.

“This also reduced the levels of national and international expertise available and took well-trained health personnel and support systems away from reproductive health to work elsewhere,” he said.

The near collapse of the sector, he said, may have resulted in yet another problem for the ministry of Public Health.

“Family planning clinics closed down, resulting in an unmet supply in the demand for family planning products. People started importing all kinds of contraceptives, some chemical-based, others of a herbal nature,” he said. “As a result, there was the emergence of quacks who filled in to meet this demand.”

Despite the fact that Kenya was one of the first countries in the sub-Saharan Africa to develop a national population policy, the policy remained unimplemented until 1977, when findings from the World Fertility Survey (WFS) indicated that Kenya had one of the highest fertility rates in the world — eight children per woman.

But with the promise of more support from donors, family planning institutions aimed at significantly lowering birth rates.

An official at a family health organisation, who asked not to be named in this story, said that their target was to reduce this number to three children per woman by 2015 and to two children per woman by 2050.

“This is the only way we will have a population that will not strain the country’s resources,” he said.

Increased funding

The family health providers say that increased funding would go a long way in improving the rates of contraceptive use among Kenyans.

Contrary to popular belief, it has been found that family planning is most common among unmarried couples rather than those who are married.

It has been established that as young couples enter into longer relationships, the use of condoms for protection against pregnancy as well as for disease prevention declines.

Mr Odhiambo attributes this to the manner in which some contraceptives have been marketed, as well to as to various myths associated with contraceptive use.

Contraceptives

“Some of the most readily available contraceptives like condoms have not been marketed as contraceptives but as disease-prevention tools. Once a new couple begins to trust each other on health matters, they shun condom use and expose themselves to unwanted pregnancies,” said Mr Odhiambo.

This perceived trust and failure to use contraceptives, Mr Muchira said, has led to yet another problem.

“Approximately 308,000 unsafe abortions occur in the Kenya annually. About 48 per cent of the abortions occur among women aged 14 to 24 years, most of who assume to be in steady relationships,” he said.

Family planning among married women with a primary school education or lower decreased from 23 per cent to 16 per cent between 1998 and 2003, the period of study.

Use among those with a secondary school level of education increased from 52 to 62 per cent.

Contraceptive use among currently married urban women stands at 48 per cent of the population, which is significantly higher than the current 37 per cent of rural women who used contraception. But the poor, the report says, have been the hardest hit by donor withdrawal from the family planning sector.

“Although the report shows low contraceptive use among all age groups, those most affected are urban teenagers in Nairobi, who recorded substantial increases in pregnancy rates between 1998 and 2003,” Mr Odhiambo said.

More than half of all teenage girls in Nairobi with no formal education are pregnant at any given time.

Data from FHOK shows that 57 per cent of women seeking abortions are from urban areas.

“We need to control child-bearing. If population continues to grow at this rate, we will find ourselves in a crisis,” he said. a crisis,” said Barasa of IPAR.

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Sat Aug 29 18:49:22 EAT 2009

After years of minimum funding to family planning and reproductive health services, the United States Agency for International Development (USaid) recently announced a major increase in funds for family planning and reproductive health activities in Kenya.